MaxGuard · Limited medical · First Health Network

MaxGuard $600

EPO

Budget-friendly basics: doctor visits, urgent care, ER, and telehealth up to plan limits. Not major medical.

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Published monthly rates

The plan's published monthly contributions by age band. Membership and admin fees are added at enrollment.

Age band	Member only	Member + spouse	Member + kids	Family
18 – 29	$309	$599	$501^est.	$791^est.
30 – 44	$349	$639	$565^est.	$855^est.
45 – 54	$379	$679	$614^est.	$914^est.
55 – 64	$429	$689	$695^est.	$955^est.

Member-only and member + spouse rates are published; kids and family figures are our estimates (est.).

What you pay for care

Deductible (in-network)$600 / $1,200 family

Doctor office visit$50 after deductible

Specialist visit$50 after deductible

Urgent care$50 after deductible

Emergency room$300 copay after deductible · max 3 visits per year

Telehealth$0 via MyLiveDoc — 12 virtual primary-care visits, unlimited virtual urgent care, 4 mental-health triage visits per year

Preventive careCovered 100% within plan limits

Benefit limits on this plan

MaxGuard is a limited medical plan — each service has a fixed benefit, and care beyond these limits is your responsibility.

Office visits: $50 copay after deductible, 10 combined visits per year (doctor + specialist + urgent care)
Emergency room: $300 copay, max 3 visits per year
Ambulance: $500 copay, once per year (ground + air combined)
Outpatient surgery: $250 copay, max 3 per year — elective surgery not covered
Hospital stay: $850 per admission, max 3 admissions per year, 10-day limit per stay
Medical equipment: $100 per item, $500 max per year
Outpatient mental health and dialysis: not covered
Pre-certification required for hospital, imaging, surgery and more — skipping it costs a 50% penalty up to $2,500

Prescription coverage

Pharmacy through Ventegra on a Mini-MEC formulary: covered generics are $0 at retail. Home-delivery generics via ScriptCo. Brand-name drugs are only available through patient-assistance programs (ScriptAide). Specialty medications are not covered.

Worth knowing

Not major medical — benefits are capped per service
Office visits capped at 10 per year across all doctors
Brand-name drugs only via assistance programs
Outpatient mental health not covered
Dialysis not covered

All plans require joining the Working Owners group: a 2-minute health survey each month that pays you $10/month.

These are self-funded association group plans, not ACA marketplace coverage. Eligibility depends on a short health questionnaire. Specialty medications are excluded on all plans. Rates shown exclude membership and admin fees, which are disclosed at enrollment.